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Colic

Topic Overview

What is colic?

All babies cry, but sometimes a
baby will cry for hours at a time, no matter what you do. This extreme type of
crying in a baby between 3 weeks and 3 months of age is called colic. Although
it is upsetting for parents and caregivers, colic is normal for some babies.

Doctors usually diagnose colic when a healthy baby cries more than expected: more than 3 hours
a day more than 3 days a week for at least 3 weeks in a row. Colic is usually worst when babies are around 6
to 8 weeks of age and goes away on its own between 8 and 14 weeks of
age.

It is common to feel scared, upset, or frustrated when you
cannot get your baby to stop crying. But remember that colic is normal-and
temporary. Your baby will grow out of it.

What causes colic?

Doctors are not sure what
causes colic, but it may be the result of a baby's sensitive
temperament and an immature nervous system. These
things may make a baby cry easily and have trouble stopping. As babies grow and
develop, they are better able to control their crying.

Colic is
not related to health conditions, such as digestion problems. But having gas in
the belly can make crying worse.

Colic is not caused by pain or
illness. If you think your baby is crying because he or she is hurt or sick,
call your doctor.

Colic is not your fault or your baby's fault.
It doesn't mean that you are a bad parent or that anything is wrong with your
baby.

What are the symptoms?

Most babies will cry less
when they are held, fed, and given attention. These things may not work for
babies who have colic. When they are crying, they may clench their fists and
stiffen their stomach and legs. Some babies arch their back, while others pull
up their legs to their stomach.

Vomiting, diarrhea, fever, or
blood or
mucus in the stool is not a
symptom of colic. If your baby has any of these symptoms, he or she needs to be
checked by a doctor.

How is colic diagnosed?

If you are worried about
your baby's crying, see your doctor or talk about it at your baby's next
routine checkup. To make sure that crying is colic, your doctor may do a
physical exam and ask you about your baby's past health, what comforting
techniques you have tried, and whether you have noticed any other symptoms. You
may also be asked about how the crying affects you and to show how you feed and burp
your baby. Your doctor may suggest that you keep track of when and how often
your baby cries.

If your baby has any symptoms that worry you,
such as vomiting or a fever, your doctor may do lab tests or X-rays to find out
what is causing them.

What can you do about colic?

It may help to see if
there is a pattern to your baby's crying. Many babies cry most in the late
afternoon and evening hours. If you notice that your baby cries at certain
times of day, you can try holding your baby more before those times. But during
expected fussy times, limit visitors, keep noise and lights low, and touch your
baby only if needed.

After crying starts, try rocking your baby in
a quiet room, or take him or her out for a walk in a front-pack carrier or
stroller. Some babies are soothed by riding in a car or listening to a droning
sound, like a fan or a clothes dryer.

Do what you can to comfort
your baby, but accept that sometimes nothing works. If you feel stressed or
worn out, ask a friend or family member to give you a break. Take good care of
yourself, and remember that colic will go away soon.

What to Expect

Similarities and differences between normal crying and colic

Because infants cry more in their first 3 months than at
any other time in their lives, it is often difficult to tell the difference
between
colic and
expected crying behavior. Both types of crying
gradually increase, peaking at about 6 to 8 weeks of age. Most crying episodes
occur in the late afternoon and evening hours, although the timing may vary.
The length and intensity of crying episodes also may change from one day to the
next.

The difference between colic and normal crying behavior is
related to the frequency, duration, and intensity of crying. Babies with colic
typically cry for more than 3 hours a day more than
3 days a week for at least 3 weeks in a row. A colicky baby cries very
loudly, sometimes piercingly, and often continuously. During a colic episode,
babies may clench their fists and stiffen their stomach and legs. Some babies arch their backs, and others pull up their legs to their
stomachs.

Most babies with typical crying behavior are soothed and
will cry less when they are held, fed, and given attention. But babies with
colic are not easily soothed after they start crying. And their episodes
typically last longer than expected.

Colic is usually worst when
babies are around 6 to 8 weeks of age and goes away on its own between 8 and 14
weeks of age.

Other problems that can cause crying

By
definition, colic is not caused by pain or discomfort. Most likely, your baby's
crying is normal. But health problems or injuries can cause a baby to cry or
make a colicky baby's crying worse.

Learn ways to tell the difference between
normal colic and
signs of a medical problem. For example, a baby may cry more when he or she
has a
digestion problem such as
milk protein intolerance or
milk sugar intolerance. Some mothers also say they notice their baby's crying
gets worse after they have had
certain foods or drinks and then
breast-feed. Some foods may affect breast milk, such
as garlic, broccoli, fresh fruits, and caffeine. They may contribute to
intestinal gas or other digestive problems in the baby.

Home Treatment

After your baby has
started to cry, use comforting and soothing techniques to try to shorten the
episode or decrease its intensity. Certain preventive measures may also help. Colic gradually goes away on its own, regardless of what you do.

Prevention

Keep a
diary to chart your baby's daily activities, including
when he or she cries. The record may help you to notice patterns in your baby's
crying and increase your ability to predict when colic episodes are likely to
occur. You may be able to help prevent or decrease crying episodes during those
times:

Anticipate your baby's needs. Pay attention to your baby's natural habits and set a rough schedule for meals,
nap, and play. That way, you can predict behavior and respond appropriately.
You may also want to try holding and comforting your baby before his or her
usual crying time. Use a front carrier or sling so you can do other things
while you keep your baby close to you.

Create a calm environment. During expected
fussy times, touch your baby only if needed, and try to limit visitors, bright
lights, loud noises, and chaotic situations. Overstimulation can trigger a
crying episode or make one worse.

Reduce stress. Babies are very sensitive to the
moods of their caregivers and may cry more during times of family
stress or tension.
Take good care of yourselves to help keep your baby's environment calm and
safe. Remember that this challenging time won't last, and know that you have
personal limitations.

Ask for help when you need it. It may help
shorten a crying episode by having another caregiver try to soothe your baby
during times when you feel overwhelmed and discouraged. Your baby may respond
better to someone who is "fresh" and relaxed. Plan ahead by scheduling help
before you need it. Have a list of people to call in case you need help
unexpectedly.

Colic is not caused by health problems. But
when your baby doesn't feel good, crying episodes may get worse. You can help
minimize colicky behavior by taking preventive measures to reduce your baby's
risk of illness.

If you are breast-feeding,
be aware of your diet. The foods you eat may affect your breast milk and
cause abdominal (belly) pain in your baby, which may extend a crying episode.

Feed your baby appropriately. Very young babies may be hungry 1
to 2 hours after a feeding. Offer food on demand. But to avoid
overfeeding, be sure to watch for when your
baby is full.

Help prevent
abdominal gas in your baby. Gas can cause pain,
leading to extended crying.

Practice good hygiene to avoid
illness. A sick baby usually has more frequent and intense crying episodes. To
help prevent illness as much as possible, use good hygiene, such as
washing hands frequently, including your baby's. Ask
visitors to do the same. Avoid being around large crowds during a baby's first
weeks, especially around people who smoke. Breathing in
secondhand smoke can increase a baby's risk for
respiratory problems,
ear infections, and
asthma.

Comfort

After a colic episode begins, comforting
measures may help.

Respond to the crying quickly and
appropriately. Quickly assess whether a cry likely indicates "I'm hungry" or "I
need to be changed," and so on, and act accordingly. Doing so may prevent your
baby from getting so upset that he or she cannot be consoled. For more
information on figuring out what your crying baby needs, see the topic
Crying, Age 3 and Younger.

Burp your baby, especially if you suspect abdominal gas started the crying
episode.

Reduce the activity around your baby. Overstimulation from
noise, lights, and too much attention can trigger a crying episode. Move your
baby to a quiet and calm environment.

Try
infant massage. Some parents use infant massage to try
and relieve colic. Research does not show one way or the other whether this
method helps babies with colic.footnote 1

Soothe your baby by helping him or her to be more
comfortable. Don't worry that you may be spoiling your baby by giving frequent
and loving attention.

Shake or spank your baby for crying. Serious or even
fatal brain injuries may result (shaken baby syndrome).

Give your baby
medicine unless it is recommended or prescribed by
your doctor.

Some doctors prescribe probiotics, which are bacteria that help maintain the natural balance of organisms (microflora) in the intestines. Studies are being done to find out how helpful probiotics are for babies who have colic.

Self-care

It is important to
take care of yourself and remember that colic is not caused by poor
parenting. Colic is temporary, and it will not affect a baby's general health
or future development.

If nothing seems to console your baby,
keep trying comforting techniques, but realize that sometimes nothing works. If
you are not successful and you become exhausted by these efforts, ask for
someone else to take over for you.

When to Call a Doctor

Call 911 or other emergency services immediately if:

You are afraid that you are about to harm your
baby and you cannot find someone to help you.

Feel that you are not able to
nurture or emotionally connect with your baby.

Who to see

The following health professionals can examine your baby and diagnose colic
or other conditions that may be related to excessive crying. They can also help
you handle the common frustrations of having a colicky baby.

Routine Checkups

You can ask your doctor about your
concerns regarding your baby's crying during regularly scheduled
well-baby visits. But don't hesitate to call and
discuss your concerns at any time. This is especially true if
comfort measures keep failing or if you notice other
symptoms along with the excessive crying.

If the baby cries excessively and has other worrisome
symptoms (such as vomiting, diarrhea, blood or mucus in the stool, or fever),
lab tests or
X-rays may be done to help the doctor find out whether
a condition other than colic is present.

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